Drugs that I always see and never know... Flashcards
1
Q
Cyclophosphamide: MOA, use
A
- alkylating agent that cross-links DNA ==> apoptosis
- uses
- non-Hodgkin’s lymphoma
- breast/ovarian cancer
2
Q
Naloxone
A
MOA: mu-opiod receceptor antagonist
use: opiod/heroin overdose
3
Q
Flumazenil
A
- MOA:
- use: benzodiazepine antagonist/overdose
4
Q
Haloperidol
A
- MOA:
- Use
- anti-psychotic
- delirium
- tranquilization in agitated patient
5
Q
Lorazepam
A
- Benzodiazepine
- MOA: allosteric modification of a specific kind of neurotransmitter receptor, the GABAA receptor, which increases the overall conductance of these inhibitory channels
- Use:
- acute anxiety
- status epilepticus
6
Q
Morphine: MOA
A
- agonist @ Mu opioid receptors
- Mu opoid receptors = GPCR ==>
- activation of K channels ==> increased K efflux
- ==> hyperpolarization ==> termination of pain signaling from nerves
7
Q
Isoproteronol MOA
A
- agonist at B1 and B2 receptors w/no alpha receptor activity ==>
- increase in cardiac contractility (B1)
- vascular smooth muscle relaxation (B2)
8
Q
Tx of acute mania
A
- mood stabilizers = lithium, valproate, carbamazepime
- atypical antipsychotic = olanzapine
9
Q
colchicine: MOA/use/SE
A
- inhibition of microtubular polymerization ==> prevention of aggregration ==> disrupts chemotaxis and phagocytosis
- also inhibits formation of leukotriene B4
- use = acute gouty arthritis
- SE = nausea, abdominal pain, diarrhea
10
Q
Enoxaparin: MOA
A
- low molecular weight heparin
- MOA: binding and activating antithrombin III
- active ATIII prevents factor Xa from: prothrombin ==> thrombin
- ==> anticoagulant effect
11
Q
Digoxin clearance
A
via kidneys
12
Q
Glucorticoids stimulate…?
A
liver (gluconeogenesis/glycogenolysis)
13
Q
Valproate during pregnancy ==> ?
A
- neural tube defects due to inhibition of folic acid absorption @ intestine
- meningocele, spina bifida, etc.
14
Q
Ebstein’s anomaly association/presentation
A
- “Ebstein’s anomaly” = “atrialization” of R ventricle due to downward displacement of tricuspid valve
- associated w/mother use of lithium during early pregnancy
15
Q
Tx/recommendations after total gastrectomy
A
- parental B12
- to avoid dumping syndrome (colicky ab pain, nausea, diarrhea)
- small meals
- low dietary intake of simple sugars
16
Q
Isoniazid side effects
A
- peripheral neuropathy (if given w/pyroxidine)
- hepatotoxicity
- usually mild ==> transient elevated AST, ALT
- elevated bilirubin
- fever, anorexia, nauseau
- severe ==> liver dysfxn, jaundice, bilirubinuria
17
Q
Hib vaccine + importance
A
- composed of polyribosyl-ribotol-phosphate (PRP) = component of Hib capsule
- [conjugated w/diptheria or tetanus toxoid]
- ==> lasting immunity against Hib in children
- H. flu ==> epiglottitis
18
Q
Raloxifene: MOA
A
- SERM
- estrogen agonist @ bone ==> prevention of osteoporosis
- estrogen antagonist @ breast ==> prevention of breast cancer
19
Q
Atenolol: MOA + effects
A
- B1 receptor antagonist
- @ cardiac tissue and JGA, but not @ vascular smooth muscle
- ==> decreased cAMP @ cardiac/renal
20
Q
Tx of organophosphate poisoning
A
- Atropine: reversal of muscarinic sx; no effect on nicotinic receptors
- pts still at risk for muscle paralysis
- Pralidoxime: reverses muscarinic and nicotinic effects of organophosphates
- effective only if given early after the exposure
21
Q
Drug effects:
tachyphylaxis =
additive =
synergistic =
permissive =
A
- tachy = decreased drug response w/repeated administration
- additive/synergistic = two drugs with similar actions
- additive = admin of both is equal to the sum of the effects
- synergistic = admin of both leads to effects exceeding the sum of the drugs individually
- permissive = admin of a different type of drug (without its own action @ desired site) leads to increased action of an effective drug if given together
22
Q
AChE in amniotic fluid ==> dx?
A
- Neural tube defects = failure of fusion of neural tube during 4th week of fetal development
- ==> leakage of fetal CSF ==>
- elevated alpha-fetoprotein
- crosses placenta ==> elevated alpha-fetoprotein @ mother serum
- acetylcholinesterase
- elevated alpha-fetoprotein
23
Q
Iodine transport @ thyroid
A
- sodium-iodide symporter brings iodine into thyroid against concentration gradient
- NIS is also responsible for transporting perchlorate and pertechnetate into thyroid
- if potassium perchlorate is present ==> competitive inhibition
24
Q
Drugs that interfere with iodine uptake
A
- antithyroid thionamides
- methimazole ==I thyroid peroxidase ==> blocked conversion of iodide to iodine
- propylthiouracil
- usually stopped 7-10 days before tx w/radioactive iodine for hyperthyroidism
25
Dobutamine impact on pressure-volume loop
* ==\> increased contractility
* ==\> higher pressures during ventricular ejection phase + greater volume expelled
* ==\> widening of P-V loop
26
Tx for severe asthmatics
* anti-IgE drugs to help reudce allergy triggers of asthma
* e.g. Omalizumab ==\> patients w/mod-severe allergic asthma
* IgG1 monoclonal antibody
* binds to IgE to prevent action of IgE w/its receeptor on mast cells ,basophils and other cells
27
Anti-metabolite drugs
* Folate antagonist
* Methotrexate
* Purine Analogs
* 6-thiopurines
* 6-mercaptopurine
* 6-guanopurine (?)
* Fludarabine ==\> CLL tx
* Cladribine ==\> HCL tx
* Pyrimidine Ananologs
* 5-FU
* Capecitabine
* Cytarabine
* Gemcitabine
28
Vinblastine: MOA, SE
* MOA:
* inhibits MT formation of mitotic spindle
* SE:
* alopecia
* constipation
* myelosuppression
* neurotoxicity (rare)
29
Cancer drugs that act in the M phase of the cell cycle
* vinca alkaloids=inhibit MT fxn/spindle formation
* vincristine
* vinblastine
* paclitaxel
* binds to tubulin and hyperstabilizes MTs that have already polymerized ==\> prevents spindle breakdown
30
5-fluorouracil: MOA, use
* anti-metabolite
* prevents formation of thymidine vua inhibition of thymidylate synthase
* uses
* slow-growing solid tumors:
* breast
* ovarian
* pancreatic
* colorectal
* gastric carcinomas
31
6-mercaptopurine: MOA, use
* anti-metabolite
* inhibits formation of purines
* use = cancer drug
32
Methotrexate: MOA, use
* anti-metabolite
* inhibts dihydrofolate reductase ==\> inhibition of DNA synthesis (via same pathway as 5-fluorouracil)
* use = cancer drug
33
Busulfan: MOA, use
* DNA alkylating agent (cell cyle nonspecific)
* use = CML
34
Bleomycin: MOA, use, SE
* inhibit replication by inducing DNA strand breaks via free radical formation
* strand breakage interrupts G2 phase of cell cycle (after DNA synthesis)
* uses: testicular tumors, lymphomas, squamous cell carcinoma
* SE
* rales, cough
* infiltration ==\> fibrosis
35
Cyclophosphamide: MOA, uses, SE
* DNA alkylating agent (cell cycle nonspecific)
* activated by CYP450
* ==\> apoptosis via DNA crosslinking
* uses
* leukemias, lymphomas
* testicular and gyn cancers
* SE
* hemorrhagic cystitis
36
How to prevent major side effect of cycloposphamide
* prevent hemorrhagic cystitis via:
* adequate hdration
* IV injection of mesna
37
Methotrexate rescue
* folinic acid aka n-formyl-xxxx aka leucovorin
* acts synergystically with 5FU
38
Common method of chemotherapy resistance
* human multi-drug resistance gene (MDR1)
* p-glycoprotein = transmembrane ATP-dependent efflux pump
* broad specificity for hydrophobic compounds
* decreases drug entry and increases efflux
39
Diuretic overuse impact on blood pH/gases
* diuretic overuse ==\> compensatory increase in aldosterone
* aldosterone ==\> sodium + H2O retention + K+ and H+ loss @ kidneys ==\> metabolic alkalosis
* "contraction alkalosis"
* labs = high pH, high HCO3, high pCO2
40
Characteristics of drugs w/various volume of distribution
* low Vd = 3-5 L
* highly bound
* charged
* hydrophillic
* high molecular weight
* Vd = 14-16L = plasma + interstitial fluid
* small molecular weight
* hydrophillic
* Vd = 41L = highest distribution
* lipophillic (or hdyro)
* uncharged
41
Isoniazid: MOA
* antimycobacterial
* inhibits **mycolic acid synthesis**
42
Buspirone: MOA/properties, use
* MOA: partial 5HTA1 agonist
* no muscle relaxant
* no anti-seizure
* little hypnosis/hallucinatory
* Use:
* anxiety
* esp. @ previous abusers of anxiolytics
* less addiction potential vs. benzos
43
a1 receptors location + effect + drugs (agonists)
* pupil sphincter ==\> mydriasis (dilation)
* bladder ==\> sphincter contraction
* peripheral blood vessels ==\> increased SBP
* agonists
* norepi
* epi
* phenylephrine
* methoxamine
44
beta-1 receptor locations + effects + agonist drugs
* heart ==\> increased HR, contractility
* agonsits
* epinephrine
* dobutamine
* dopamine
* isoproteronol
45
beta-2 receptor locations + effects + agonist drugs
* bronchi ==\> bronchodilation
* uterus ==\> relaxation
* skeletal muscle bood vessels ==\> vasodilation
* agonist drugs
* isproteronal
* terbutaline
* ritodrine
46
How long till continuous infusion or drug reaches steady state?
* IF: continuous infusion + elimination via first-order kinetics ==\>
* steady state plasma concentration @ 4-5 half lives
47
Presentation of ethylene glycol toxicity
* ethylene glycol metabolized ==\> glycolic acid & oxalic acid
* anion-gap metabolic acidosis
* calcium oxalate crystals in urine
* increased osmolar gap
* acute kidney injury/renal failure
* damage to tubular epithelium
* vacuolization
* ballooning
48
Presentation of theophylline toxicity + tx
* theophylline ==\>
* N/V + abdominal pain
* arrhythmias
* seizures \*\*
* Tx
* gastric lavage
* activated charcoal
* cathartics (increase elimination via GI tract)
* beta-blockers ==x arrhythmias
* benzodiazepines & baribituates ==x seizures
49
Lithium: indications, side effects
* bi-polar; manic and depressive episodes, maintenance
* SE
* DI
* tremor
* hypothyroidism
* Epstein's anomaly
50
Valproate: indications, SE
* manic episodes; maintence in bipolar & generalized/absence/myclonic seizures
* SE
* hepatotox
* NTDs
51
Carbamazepine: indications, SE
* manic episodes, maintence
* partial generalized seizures
* trigeminal neuralgia
* SE
* agranulocytosis
* NTDs
* hyponatremia (SIADH)
52
Lamotrigine: indications, SE
* depressive episodes, maintenance in bipolar
* focal seizures
* SE
* stevens-johnson
* benign rash
53
Mood stabilizers in bipolar
* lithium
* valproate
* carbamazepime
* lamotrigine
54
Use/Effects:
Physostigmine vs. Neostigmin vs. Edrophonium
* all AChE inhibitors
* use = reverse atropine toxicity
* neostigmine/edrophonium = only fxn @ peripherphy; cannot penetrate CNS
* physostigmine = fxns @ periphery & CNS
55
5HT3-inhibitors
* ondansetron
* granesetron
* dolasetron
56
Rapid and complete relief in RA [short-term]
glucocorticoids, e.g. prednisone
57
Nevirapine: MOA, similar drugs
* NNRTI
* inhibits reverse transcription, doesn't need phosphorylation to be active
* other drugs
* efavirenz
* delaviridine
58
Canagiflozin: MOA, use, SE
* MOA
* oral anti-diabetic
* = SGLT2 inhibitor ==\> decreased reabsorption of glucose @ proximal renal tubule
* ==\> urinary glucose loss
* SE
* renal effects
59
Lithium toxicity antidote
hydrocholorthiazide ==\> trapping in urine
60
thiopental: moa, use
* lipid-soluble barbituate used as short-term anesthesia
* ==\> brain ==\> rapid redistribution to skeletal muscle and adipose tssue (w/in 5-10min)
* rapid redistribution allows for short term anesthia
61
Characteristics of serotonin syndrome
* occurs when SSRIs are given in conjunction w/other serotonergic agens
* sx
* neuromuscular excitation: hyperreflexia, clonus, myoclonus, rigidity
* autonomic stimulation: hyperthermia, tachycardia, diaphoresis, tremor
* AMS
62
Examples of serotonergic agents
* Anti-depressants
* monoamine oxidase inhibitors
* TCA
* SNRI
* analgesics
* tramadol
* anti-emetics
* 5-HT3 receptor antagonists (ondansetron)
* antibiotics
* linezolid = weak monoamine oxidase inhibitor
* neuropsych
* triptans
63
Tx tp prevent recurrences of genital herpes
* daily treatment with oral valacyclovir, acyclovir, or famciclovir ==\> suppression of reactivation
64
Amphotericin B: MOA, SE
* MOA = binds ergosterol ==\> pores ==\> cell death
* SE
* renal toxicity
* ==\> vasoconstrict ==\> decreased GFR
* direct toxin to renal epithelial cells ==\> ATN, renal tubular acidosis, and electrolyte distrubances
* \*\*hypoK and hypoMg
* ==\> decreased EPO ==\> normochromic, normocytic anemia
65
Antifungal that inhibits fungal cell wall synthesis
* Capsofungin
* inhibits synthesis of cell wall polysaccharide glucan
66
Phenytoin SE/toxicity
1. CNS effects ==\> cerebeller defects/ataxia
2. gingival hyperplasia
1. pheny ==\> increased PDGF ==\> stimulated macs to proliferate gingiva and alveolar bone
3. coarsening of facial features, hirstruism
4. interferes w/folic acid metabolism ==\> megaloblastic anemia
5. induces P450
6. teratogen ==\> fetal hydantoin syndrome
67
Phenelzine: drug class, use, other similar drugs
* MAOIs
* Atypical depression = mood reactivity (to positive events), leaden fatigue, rejection sensitivity, increased sleep and apetite
* others
* tranylcypromine
68
Rare, serious side effect of ACE-i
* angioedema = face, lips, tonuge, eyelids, larygneal edema ==\> difficulty breathing
* most likely due to elevated bradykinin levels
69
SE: Orange/red body fluids ==\> drug + MOA?
* Rifampin
* ihibits DNA-dependent RNA synthesis (bacterial RNA pol)
70
Contraindications for use of OCPs
1. Prior thromboembolic event/stroke
2. hx of estrogen-dependent tumro
3. women \> 35 who smoke heavily ==\> higher risk of CV events
4. hypertriglyceridemia
5. decompensated or active liver disease
6. pregnancy
71
Causes of exacerbation of mysathenia gravis
* myasthenic crisis = undertx
* cholinergic crisis = overtx
72
Antidote for serotonin syndrome
* cyproheptadine = antihistamine + anti-serotonergic properties
73
Verapamil: MOA, use, SE
* MOA = non-dihydropyriddine ca-channel blocker
* slows conduction through AV nodes
* use = rate control in afib w/rapid ventricular response
* SE
* constipation
* gingival hyperplasia
* bradycardia
* first, second, or third degree AV node block
74
Leoprolide impact @ male
* GnRH
* transient increase, then decrease in both T and DHT
75
Vancomycin: MOA vs. Ceftriaxone: MOA
* Vanc binds D-ala (glycoproteins @ cell wall of bacteria)
* Ceftriaxone binds PBPs
* PBPs = transpeptidases that cross-link peptidoglycan @ cell wall
76
Beta blocker effects in thyrotoxicosis
* decrease noradgrenergic responses
* decreased T4 ==\> T3 conversion @ periphery
77
Anti-pseudomonals
* Pip-Taz
* [some] Cephs
* Cefatadazine
* Cefepime
* Gentamicin
* [some] fluoro
* ciprofloxacin
* levofloxacin
* carbapenems
78
Heparain: MOA
* binds antithrombin III and increases action
79
Drug-induced lupus: association
* drugs metabolized by liver acteylation
* hydralizine
* procainamide
* slow-acetylators are @ higher risk
80
Mast stablizing agents
* cromolyn
* nedocromil
* inhibit mast cell degranulation regardless of stimuli present
* 2nd line for tx of allergic rhinitis and bronchial asthma
81
Niacin SE
* vasodilation ==\> flushing
* can potentiate anti-htn meds ==\> dosage decrease
* ==\> increased insulin resistance
* ==\> dosage increase in DM meds
82
Acetozolamide: MOA, use
-MOA: inhibits CA @ proximal tubule ==\> excretion of HCO3- + sodium ==\> diuresis + alkaline urine + metabolic acidosis -use: open & close-angle glaucoma, others
83
DRESS syndrome
-Drug Rxn with Eosinophilia & Systemic Sx -2-8 weeks after starting new medication -esp. anticonvulsants, antibiotics, allopurinol, sulfonamides -fever, general lymph, facial swell, eosino, skin rash, organ dysfxn
84
Drug-induced lupus
-hydralazine (HTN drug, arteriolar vasodilator via K channel binding) -procainamide -isoniazid
85
opioid drug that can produce w/drawal in someone on morphine
pentacozine
86
Selegiline: MOA
MAO-B inhibitor
87
Methotrexate toxicity antidote
Folinic acid
88
Characteristics of digoxin toxicity
-nonspecific GI = N/V, abdominal pain, anorexia -neurologic = fatigue, confusion, weakness, sometimes: color vision changes -most serious complication = arrhythmias
89
Drugs not to use with partially occluded coronary arteries
-coronary artery vasodilators -vasodilation of unoccluded arteries ==\> reduced blood flow through collaterals to ischemic areas ==\> worsening ischemia
90
Which of these drugs would cause bradycardia: -Nifedipine -Captopril -Verapamil -Isosorbide nitrate -Prazosin
-verapamil only -all others act peripherally
91
Drugs with negative chronotropic effects @ heart
-B-blockers -non-dihydropyridine Ca-channel blockser (verapamil, diltiazem) -cardiac glycosides (digoxin) -Amiodarone and sotalol -Cholinergic agonists (pilocarpine, rivastigmine)
92
Drug effect of sildanefil is similar to what naturally occuring hormones/mechanisms
1. NO 2. ANP all ==\> increased cGMP
93
DDAVP: moa, use
-vasopressin analog -little affect @ V1 receptors ==\> no vasoconstriction -use: 1. central DI 2. bleeding control: induces release of procoag proteins (e.g. vWF) and stabilized factor VIII (Hemo A)
94
High vs. low potency antipsychotics
high = fluphenazine, haloperidol low = chlorpromazine, thioridazine
95
Class of anti-arrhythmics that show "use-dependence" + example
-class I anti-arrhymics (Na-cahnnel blockers) -IC = strongest association w/Na; slow to leave ==\> prolonged QRS, but no effect on overall AP ==\> normal QT
96
Carbamazepime: MOA, use, SE
-MOA = blocks VSSC @ neurons -use = partial, partial complex, gen TC seizures + mood stabilizer -SE = bone marrow suppression
97
Gq receptor pathway
1. binding ==\> phospholipase C converts mem. phospho ==\> IP3 & DAG 2. IP3 ==\> increased Ca release from SR 3. Ca + DAG activate PKC 4. PKC phosphorylates 2nd mess ==\> downstream effects
98
Ethambutol SE
optic neuritis, color blindness ,etc.
99
Nitrate with highest bioavailability
isosorbide mononitrate
100
Antidote for NE drip-mediated tissue necrosis
-alpha-1 receptor blocker -e.g. phentolamine
101
Tx of calcium oxalate kidney stones
hydrochlorothiazide: blocks Na/Cl transporter @ lumen ==\> activation of Na/Ca exchanger ==\> increased Na w/in cell in exchange for increased Ca reabsorbed
102
Adenosine: MOA, use, SE
-MOA: slowing conduction through AV node by hyperpolarizing nodal & conducting cells -use: drug of choice in paroxysmal SVT -SE: flushing, chest buring (bronchospasm), hypotension, high-grade AV block
103
Reason for methodone use
* used to help patients recover from heroin addiction
* very long half-life opioid agonist w/good oral bioavailablity
* prevents withdrawal sx while weaning off heroin
104
Common causes of myopathy with elevated CK
* inflammatory myopathy
* skin rash and inflammatory arthritis may also be present
* statin-induced
* hypothyroidism
* hypothyroid sx present
* myoedema = mounding of m. after percussion
105
Ipratropium: MOA, use
* Muscarinic antagonist @ bronchial smooth m.
* less effective than B2 agonists
* enhance B2 agonists
* use in asthma
106
Theophylline: MOA, use
* MOA: inhibit phosphodiesterase ==\> increased cAMP ==\> bronchial sm. m. dilation
* use: asthma
107
Nicotinic receptors
* ligand-gated ion channels
* ACh binding ==\> immediate influx of Ca2+ and Na+ and efflux of K+
108
Clozapine: MOA, use, SE
* MOA: blocks D4 receptors
* use: refractory psychosis/schizophrenia
* SE
* agranulocytosis
* seizures
109
Insulin types
* Basal/long-acting
* Glargine; Determir = once daily
* NPH = twice daily
* Short-acting/post-prandial
* Regular = best for IV
* Lispro, Aspart, Glulisine = peak @ 45 min - hour
* best for post-prand hyperglycemia
110
Common disinfectant mechanisms:
alcohols
chlorhexadine
hydrogen peroxide
iodine
* alcohols
* disruption of cell membranes
* denaturation of proteins
* chlorhexadine
* disruption of cell membranes
* coagulation of cytoplasm
* hydrogen peroxide
* free radicals
* sporocidal
* iodine
* halogenation of proteins & nucleic acids
* sporocidal
111
Tx of idiopathic pulmonary HTN
Bosentan = endothelin antagonist ==\> vasodilation @ pulm. artery
112
Sotalol: MOA, SE
* MOA
* K+ channel blocker
* + mild B-blocker effects
* Class 3 anti-arrhythmic
* amiodarone
* ibutilide
* dofetilide
* SE
* mild bradychardia
* prolonged QT interval
113
First-line drug for benign essential tremor + SE
* Primidone ==\> active metabolites = phenobarbitol (+ phenylethylmalonimide) ==\> anticonvulsant effects
* must monitor levels ==\> AMS, sedations
114
Hyperthyroid sx that does not improve w/beta blockers
exopthalmos = due to fibroblast proliferation and ground substance production
115
Drug that ==\> vasodilation + blocks platelet agg. used in PAD
Cilosotazol
116
Isoniazid: MOA, resistance
* inhibits mycolic acid formation
* must be processed by mycobacterial catalse-peroxidase to become active
* resistance:
* change mycolic acid structure/isoniazid binding site
* decreased activity of catalase-peroxidase
117
Glucagon receptor type + other hormones w/same receptor
* G-protein coupled receptor
* binding ==\> activated Adenylate Cyclase ==\> increased cAMP ==\> activated PKA
* other hormones
* PTH
* B-andrenergic
* TSH
118
Metoprolol effects
* B1 selective blocker
* present @ heart & JGA
* ==\> decreased HR
* ==\> blocks renin release by JGA cells
119
V2 effects @ medullary collecting duct
* ==\> increased permeability to H20 and **urea**
120
Initial treatment of severe hypoglycemia
* in the field/@home:
* less severe (mild-moderate) ==\> fast-acting carbs; e.g. fruit juice, glucose tablet
* unconscious: IM glucagon
* @ hospital: IV glucose
121
Tx for combined T-C and absence seizures
* valproic acid
122
Amphotericin B: SE
* Nephrotoxicity and electrolyte abnormalities
* ==\> hypoK and hypoMG
* hypoK ==\> T wave flat, ST-depression, U waves
123
Bethanacol: MOA
musc. antagonist
124
Calcinuerin fxn
* calc = protein phosphatase ==\> dephosph NFAT ==\> trxn factor for IL-2 ==\> T cell growth and maturation
* Cyclosporine & Tacrolimus ==I calcineurin ==\> anti-rejection/immunosuppress drugs
125
Unfractionated vs. LMWH
* unfractionated = binds ATIII and allows activity against factor Xa **and** thrombin (inactivation)
* LMWH ==\> ATIII activity against Xa only
126
Insulin receptor mechanism
* insulin ==\> tyrosine kinase ==\> insulin receptor substrate phosphorylization ==\> activation of protein phosphatase
* protein phosphatase ==\> dephosph glycogen synthase = activated glycogen formation
* also ==\> dephosph of fructose-1,6-bisphosphatase = inactive ==\> inhibition of gluconeogenesis
127
Succinylcholine: MOA, use
* MOA: depolarizing NMJ blocker
* use: rapid induction/intubation or for surgical intubation
* phase I = augmented by AChEi (e.g. neostigmine)
* phase II = reversed by AChEi
128
Methotrexate SE
* stomatitis = painful mouth ulcers
* hepatotoxicity = hepatitis, fibrosis, cirrhosis
* myelosuppression ==\> increased infection risk
* B-cell lymphomas
* pulmonary fibrosis
* contraindicated in pregnancy
129
Terbanifine: MOA
* inhibits squalene oxidase ==\> inhibition of fungal wall formation
* use = dermatophytoses; e.g. tinea corporis
130
Fluoroquinolones: MOA
* bactericidal
* inhibit DNA topoisomerase activity
131
Fluoroquinolones: adverse effects
* GI upset
* damage to cartilage @ children
* tendinitis/tendon rupture in adults
* mild
* H/A
* dizziness
* rash
132
Aminoglycosides: MOA
* bactericidal
* block bacterial protein synthesis through inhibition of 30S ribosomal unit
133
Aminoglycosides: adverse effects
* nephrotoxicity
* ototoxicity
134
Macrolides: MOA
* bacteriostatic
* blocks protein syntehesis at 50S ribosomal unti
135
Macrolides: adverse effects
* GI discomfort
* acute cholestatic hepatitis
* eosinophilia
* skin rashes
* more severe
* pseudomembranous colitis
* ventricular arrhythmias
136
Tetracyclines: MOA
* bacteriostatic agents
* block protein synthesis by actin at 30S ribosomal subunit
137
Tetracyclines: adverse effects
* GI distress
* tooth discoloration
* inhibition of bone growth @ children
* photosensitivity rxns
* more severe
* bacterial superinfection
* hepatotoxicity
138
Trimethoprim-sulfamethoxazole: MOA
* trimethoprim-sulfamethoxazole
* MOA = inhibitis bacterial folate synthesis via inhibition:
* dihydropteroate synthetase (trimetho) and dihydrofolate reductase (sulfa)
139
Penicillins: MOA
* bactericidal
* inhibition of cell wall synthesis via inhibition of cross-linking of peptidoglycan
140
Cisplatin: MOA, SE
* MOA: reactive oxygen species ==\> DNA crosslinks
* SE
* nephrotoxicity: acute tubular injury
* antidote/prevention = amifostine + IV normal saline (chloride diuresis)
* thiol-based cytoprotective free-radical scavenging agent
* ==\> decreased nephrotox
141
Argatroban: MOA, use, similar drugs
* binds thrombin active site ==\> direct thrombin inhibition
* ues = HIT
* other drugs
* hirudin
* lepirudin
142
Anastrozole: MOA, use
* MOA: aromatase inhibitor ==\> inhibition of estrogen synthesis
* use: metastatic breast cancer
